Engaging caregivers to use an evidence-based intervention for medicaid beneficiaries with Alzheimer’s disease: a pilot study

Abstract

Background This pilot study aimed to adapt an intervention, engaging informal caregivers to help clinicians with providing care to improve (or maintain) physical function of individuals with Alzheimer’s Disease or other dementias. To the best of our knowledge, for the first time, we report on use of the intervention in those with Alzheimer’s Disease or other dementias. Methods This was a 5-month mixed methods cohort study in a convenience sample of clinicians, caregivers, and beneficiaries at 3-Medicaid Home and Community-based Service sites in Michigan. Two content experts and 5 caregivers modified the intervention. We trained 116 clinicians to engage caregivers and 50 caregivers to help clinicians provide the modified intervention to 52 beneficiaries with Alzheimer’s Disease or other dementias. Thematic analyses, descriptive statistics, counts, proportion comparisons, t-tests, and McNemar’s tests were used to examine socio-demographics, clinician knowledge uptake and satisfaction with training and use of the intervention; caregiver self-efficacy, feasibility, acceptability, usability, and satisfaction with intervention and beneficiary outcomes (pre-/post). Results Feasibility (enrolled/recruited = 78.5–86.7%), acceptability (7.55–8.35 [SD 1.50–2.06]), and usability (7.85–8.81 [SD 1.50–2.6]) of the modified intervention (1 = low;10 = high) were high. Pre-/post-intervention clinician knowledge (12.33–12.28, SD 1.80–2.84; -0.52, SD 1.95) was high. Caregiver self-efficacy increased (0.81 [SD 0.62] p < 0.01). Beneficiary outcomes did not improve nor decline (> 0.05). Conclusions Engaging informal caregivers to assist clinicians with providing an intervention adapted to the needs of those with Alzheimer’s Disease or other dementias was feasible, acceptable, and usable. Further testing in a broader sample of those with dementia in various settings is needed.